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National

Under-Informed Health Care Debate

Considering how widely discussed the health care issue is and how long running that discussion has been it is easy for people to think they have all the available and relevant information on the subject. The fact is that despite the appearance of coverage you can only scratch the surface of available information unless you search beyond mainstream news sources. Here’s a letter in the  Salt Lake Tribune yesterday as a case in point:

To President Barack Obama and Congress, I say: Negotiate the various health care reform bills — soon. Get the Blue Dog Democrats on board, and pass a bill — soon, before your public becomes so weary of partisan infighting that we oppose anything you pass.

The Republicans, for all their bluster, have not offered any alternative, except our Sen. Bob Bennett with Oregon Democrat Sen. Ron Wyden, and that bill has received only token Republican support. . .

The author is right that the Health Americans Act by Wyden and Bennett has received only token Republican support – largely because it is only fleetingly different from the various Democrat only bills in circulation. On the other hand, he is far from right that Republicans have offered no alternatives – that’s just the line that Congressional leaders and the administration have been feeding to the media. Just browse the sites of Rep. Ron Paul and Sen. Jim DeMint to get an idea of some of the Republican counter-proposals that have been offered. Then consider that for every idea presented by those two members of Congress there must be dozens of ideas that were offered in negotiations before the Republicans left the tables that never received even token consideration by leaders of the various committees.

On the very day the letter was being published Rep. John Shadegg (AZ-03) was talking about one of those non-existent Republican plans that was apparently introduced back in July and cosponsored by Rep. Rob Bishop (UT-01) among others. (h/t Right Truth) As always in the health care debate, each bill should be measured against the findings of David Goldhill to see if it actually addresses the real problems in the health care system. (Shadegg’s bill appears to do better than the bills actually acknowledged by the media from what I’ve seen.)

Although I maintain that being truly informed requires that we look at more information sources than the mainstream media that also means that we have to be discerning about the accuracy of each information source. I think it’s safe to doubt the accuracy of anyone (especially an MD) that believes that our current health care system suffers from a “lack of government regulation.” I’m amazed that someone could seriously argue that the current proposals under consideration represent free market solutions and that solutions based on free market principles would be a good thing while also arguing that the free market is the cause of our health care woes.

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General

No Individual Mandate. Period.


photo credit: wstera2

When I responded to Obama’s Health Care Speech I said the following about the potential inclusion of an individual mandate in whatever health care overhaul bill is eventually debated in Congress:

In a nod to the necessity of compromise and political expediency (I do have a pragmatic bone in my body – somewhere) I will keep it out of the non-starter category and say that if it is extremely limited, as liability-only car insurance is, I could accept an individual mandate.

Scott challenged me on that position and I defended it as politically expedient. Now that I have had more time to think about it I believe that I can conclusively demonstrate why the president wanted to rush the health care legislation through before the August recess. His reason was that he understood that the longer people have to process the issue the more people will realize how little government can legitimately do to address this issue and how dangerous it is to allow Congress to employ tools that are not legitimately theirs in order to “fix the system.”

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National

Takeaways From the Health Care Speech


photo credit: sgroi

Let’s pretend that we are starting from scratch on the health care overhaul push – that none of the existing proposals will be used as the template for a reform bill. In other words, let’s assume that the plan outlined in President Obama’s speech is the primary blueprint for the reform bill that Congress will have to consider. As I predicted he tried to strike a balance between being bold and rocking the boat too much calling both better and worse plans than his “a radical shift” that would be too much for something as economically large as the health care industry.

Now that I have read the entire speech I have four non-starters, one gem, two contradictions, and five questions after his speech that deserve public reaction. I’ll start with the non-starters because they are not non-starters put together, each one must be addressed before anything he proposes can be considered in any degree.

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General

Predictable

As a political junkie you would expect that I would be endlessly fascinated by all things political and that I would be very excited to listen to a speech by the President (even if only to find things to contradict when I disagree with him). Once upon a time that would have been true, but not anymore. While I am still anxious to be engaged in politics and the political dialog I find that too much of politics is very formulaic and predictable. I can easily say what the speech by the President will be like without even listening to or reading the transcript or any report about it.

In his speech tonight the president will talk about the importance and of Health Care reform. He will take time to rebut some of the more ridiculous rumors that have been circulated by his opponents and he will make his approach to health care seem perfectly reasonable – in fact he will be trying to strike a balance of being bold while not rocking to boat too much. The overall effect of the speech will be to make many people more comfortable with the approach he is taking while conveniently masking the fact that nothing in the current Health Care reform proposals actually addresses the real issues that plague our system of health care.

The only thing I can’t predict is whether enough people will be assuaged (or lulled into a false sense of security) to get a health care bill passed as the President hopes. While I will always hope for every president the best of success for the nation, this effort by the President shows no indication of promoting what is best for the nation (except in his words) and so I continue to hope that this effort flounders until the leaders of the country are ready to look at the actual problem and craft a solution to that problem within the limits of their authority rather than looking at their political goals and trying to convince the rest of us that their goals will solve real problems.

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culture National

Wash Your Hands

[quote]Dr. Peter Pronovost sought to reduce the incidence of hospital-borne infections by promoting a simple checklist of ICU procedures governing physician hand-washing and other sterilization procedures.

Hospitals implementing Pronovost’s checklist had enjoyed almost instantaneous success, reducing hospital-infection rates by two-thirds within the first three months of its adoption. But many physicians rejected the checklist as an unnecessary and belittling bureaucratic intrusion, and many hospital executives were reluctant to push it on them.

When David Goldhill learned of this very shortly after his own father died from just such an infection he began to investigate the real problems in our health care system. As a grieving son, he wished for a culprit only to find that there really is no bad guy, no incompetent doctors, greedy insurance or drug companies, or any other scapegoat. The problem his research exposed was a system of perverse incentives and unrealistic expectations (like expecting that hundreds of thousands of deaths per year from hospital infections is acceptable or unavoidable and expecting someone else to pick up most of the cost of our care). Like Goldhill, anyone wishing to tackle the issue of health care must wash their hands of pre-programmed political prescriptions and rampant half-truths being promoted by people on all sides of the debate.

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General

The Politics of Fear

Fear
photo credit: ag2r

I was listening to NPR this morning on the way to work and they were discussing the use of fear as a political tactic. The story was not what I would consider fair and balance as they asserted that only those who oppose health care reform are making use of the tactic, but one of the people being interviewed about why fear is such an effective tool in blocking legislation stated that fear has the effect of causing us to focus on the problem and divert our energies to addressing the cause of our fear. Of course the implication is that we stop being rational when we are motivated by fear.

As I thought about that it really irked me that they paint people as nothing more than animals – it’s all biology. The truth is that while we are prone to act less than rationally when we are consumed by fear we also have a heightened capacity to think clearly in many high-pressure situations. The key to thinking clearly is that we must not let the fear overwhelm us – let the adrenaline enhance our senses without letting go of our capacity to look at the evidence and make deliberate choices.

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culture National

The Economic Bill of Rights

During his final State of the Union address Franklin Delano Roosevelt spoke about what he said could be considered a second bill of rights which may be referred to as The Economic Bill of Rights. In his address he said some important things that ring true such as:

We cannot be content, no matter how high that general standard of living may be, if some fraction of our people — whether it be one-third or one-fifth or one-tenth — is ill-fed, ill-clothed, ill-housed, and insecure.

He described the original Bill of Rights as proving itself inadequate:

This Republic had its beginning, and grew to its present strength, under the protection of certain inalienable political rights — among them the right of free speech, free press, free worship, trial by jury, freedom from unreasonable searches and seizures. They were our rights to life and liberty.

As our nation has grown in size and stature, however — as our industrial economy expanded — these political rights proved inadequate to assure us equality in the pursuit of happiness.

This is very likely the first and most blatant blurring of the nature of rights ever promoted by a president. It has set the tone for our widespread misunderstanding of what rights are as a majority (or at least a vast minority) have come to view the following as rights equal to the rights described and protected in the Bill of Rights.

  • The right to a useful and remunerative job in the industries or shops or farms or mines of the nation;
  • The right to earn enough to provide adequate food and clothing and recreation;
  • The right of every farmer to raise and sell his products at a return which will give him and his family a decent living;
  • The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad;
  • The right of every family to a decent home;
  • The right to adequate medical care and the opportunity to achieve and enjoy good health;
  • The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment;
  • The right to a good education.

As someone else has said – these are all goods, but only one of them is a “right.” The only real right is the right to trade goods and skills in an atmosphere free from unfair competition. The rest of this list are only protected as far as that one right extends – that every person has the right to not have others undercut their efforts as they labor to acquire a useful and remunerative job, enough money to provide adequate food, clothing, and recreation, a decent home, adequate medical care, protection from economic fears, and a good education.

Along with the first example I cited of things that ring true in his words is this:

People who are hungry and out of a job are the stuff of which dictatorships are made.

Both of those truisms however are incomplete. To the first I would add that no matter how low our standard of living we cannot afford to give up on true principles in exchange for popular sentiment. To the second I would alter it to say that people who are dependent on a central political authority for food and work are the true stuff of which dictatorships are made – being hungry and out of a job only make them ripe for recruitment.

It is interesting to note that as we have pursued policies to provide government funded education, economic security, and now health care in order to eliminate sickness and the economic distress of unemployment and underemployment the result is more widespread economic fears. Because of the ubiquitous belief in these so called rights many people wish to turn to government for security even where the government is the cause of the insecurity in our nation.

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National

An Effective Response on Health Care

Those who wish to oppose the current health reform plan wending its way through Congress will not succeed simply by opposing the current bill, nor by offering an equally complex alternative bill. This is a major mistake being made by those in Congress who are not ready to back the overhaul currently being proposed (mostly Republicans). The only hope is to offer a simple bill that can gain wide support and propose to pass it as a first step to real health care (or health insurance) reform.

A simple bill allowing the purchase of health insurance from other states could be just exactly the medicine this health care reform fiasco needs to turn it from the current monstrosity to a real, effective push for sustainable reform. This could not be a full solution to our health care problems but it could be an easily understandable bill that could gain wide support and show clearly that those opposing the bill being thrust upon us now are serious about reform and offering clear alternatives. In fact, such a bill plays directly to the president’s latest soundbite that the important thing to satisfy the President is that there be “choice and competition in the health insurance market.” (See remarks by Robert Gibbs among others.)

Perhaps passing such a bill would be just the thing to get the White House and Congressional leaders to come back to the bargaining table and work with the rest of Congress on this issue to get bipartisan reform (and preferably to approach reform as a series of small, easily understood bills passed in succession) instead of trying to craft their preferred bill (hiding who knows what in a massive reform bill that few people have read and nobody truly understands) and then trying to convince some Republicans to support it so that they can call it bipartisan.

I wrote to my congressional representatives to say as much. I told them:

Republicans in the House and the Senate should be able to put together such a bill (likely only one or two pages) and a coalition of support and be ready to present it in both houses of Congress as soon as the August recess is over. I’d like to see all my representatives sponsoring or cosponsoring such a bill within the first week after the Congressional session resumes.

For anyone who would like to send a similar message to their representatives (anywhere in the nation) they can do so by going to the Make Health Insurance More Affordable campaign from Downsize D.C.

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National

Nobody Wants the Status Quo

Health Care Reform Plan
photo credit: planspark

Proponents of the current health care proposals charge that those who oppose these proposals only want the status quo. No honest Democrats have stepped forward to admit the truth that opponents of these measures have been offering alternatives and decrying the status quo. The leader among dishonest Democrats today is none other than President Obama (whom I have tried to refrain from specifically criticizing) who not only will not admit the truth about opponents of his preferred reform package but who goes further by holding “town hall meetings” where no opportunity for discussion is even considered (as do many of his followers) – these are not chances to discuss and enlarge public understanding of the issue, they are opportunities to indoctrinate the masses one town hall at a time.

Nothing I have said excuses the behavior of some protesters at many town hall meetings who are equally disinterested in any actual discussion, but any real leader would have to rise above such rabble and be willing to engage and explain rather than pontificate and cajole.

Among those speaking against the current reform proposals there is a common belief that has never been addressed by backers of the proposals – that the current prescription will actually be worse than the status quo (which they agree is not an acceptable situation). Not only are they speaking against the dangerous potential of the current direction but here are a few of the ideas that are not being offered to considered by our current leaders.

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National technology

White House Viral Email

The White House has decided to use a viral email (or at least an email they hope will go viral) to spread their health care reform message. In it they offer:

8 ways reform provides security and stability to those with or without coverage, 8 common myths about reform and 8 reasons we need health insurance reform now.

It think it is important to get a non-spin version of their 24 points (really only 21). I will assume, as much as possible, that their claims are true and show what those claims really mean to the nation.  As usual it’s not nearly as straightforward as any partisan claims would have you believe. (For example, they only offer 7 unique ways reform provides security, 7 unique myths – including one I had never heard, and 7 reasons for reform now – plus one generic platitude.)